Athletics and Herbal Supplements

Why Athletes Use Herbs

Exercise is a physical stress. If the athlete’s body can manage the stress, it adapts by increasing muscle mass, optimizing metabolism or improving motor performance. If the athlete’s body cannot manage the stress, then muscle soreness, malnutrition or declines in performance may manifest. Thus exercise can serve as either a positive or negative stressor.

For example, the J-curve model proposed by David Nieman of Appalachian State University shows that individuals who exercise regularly at moderate intensities have lower incidence of upper respiratory infection events than their sedentary or rigorously training counterparts (see Figure 4). Individuals who train moderately—for example, people who run three times a week for 30 minutes—demonstrate decreased incidence of such infections compared to sedentary counterparts. On the other hand, elite athletes often demonstrate increased incidence of such infections due to the stress of their demanding training schedules. The category “very high” in Figure 4 includes individuals such as professional or Olympic athletes, but from a medical standpoint it could encompass any athletes who train at levels beyond what their bodies can accommodate. These athletes may include college and high school athletes and even so-called (often erroneously) amateur recreational athletes.

Herbal supplements appeal to the sports community because of their potential for improving performance capacity either through conferring ergogenic benefits or through offsetting the deleterious effects of rigorous training regimens. Most herbal supplements, such as ginseng and echinacea, are available over the counter, making them both legal and readily available; others, such as ephedra or ma huang, are now illegal. Whether a given supplement is illegal varies by country and sports regulatory agency; within the context of sports, illegality is often declared if a supplement engenders an unfair ergogenic benefit (“doping”) or constitutes a health threat. Ephedra, for example, is banned because it has no confirmed ergogenic benefits yet contains toxic alkaloids.

Importantly but not surprisingly, athletes’ rationales for choosing and using any given supplement are often discordant with contemporary indications, as evidenced by surveys of U.K. athletes performed by Andrea Petróczki at Kingston University, in collaboration with colleagues at the University of Birmingham and Swansea University. Their work has shown that professional athletes may use supplements for reasons other than their purported purpose; ignore advice from medical professionals despite the fact that athletes consult those professionals for advice more frequently than coaches or trainers; misunderstand side effects or assume a supplement is safe because it is “natural”; and sacrifice health benefits for perceived performance benefits. Circumstances may be different for nonprofessional, noncollegiate athletes. Many people assume that the Food and Drug Administration regulates herbal supplements, but in the United States the Dietary Supplement Health and Education Act of 1994 allows most herbal supplements to be sold without FDA approval. Vendors position herbal supplements on store shelves alongside regulated items such as vitamins, which may perpetuate this perception.